Hearing loss and activities of daily living (Bessen et al., 2025)
Purpose: Experiencing difficulty with activities of daily living (ADLs) and instrumental ADLs (IADLs) and/or the consequences of unmet ADL/IADL-related needs is associated with adverse health-related outcomes. The association of hearing loss (HL) with experiencing the consequences of unmet ADL/IADL-related needs is not well understood. We investigated the associations of HL with experiencing ADL/IADL difficulties and the consequences of unmet ADL/IADL-related needs in older adults.
Method: We investigated cross-sectional associations between audiometric HL, the number of ADL and IADL difficulties, and the number of consequences of unmet ADL/IADL-related needs among adults aged 65 years and older in the National Health and Aging Trends Study.
Results: In 4,724 older adults, 30.5% (n = 1,736) and 30.9% (n = 1,727) had self-reported difficulty with ADLs and IADLs, respectively. Of the 2,289 participants who reported difficulty with at least one ADL/IADL, 14.0% (n = 741) reported experience of at least one consequence of an unmet ADL/IADL-related need. In multivariable ordinal regression analyses, mild (OR = 1.38, 95% CI [1.1, 1.73]) and moderate or greater (OR = 1.57, 95% CI [1.17, 2.1]) HL were associated with higher odds of difficulties with additional ADLs. Moderate or greater HL was associated with higher odds of reporting difficulties with additional IADLs (OR = 1.59, 95% CI [1.19, 2.12]). There was no significant association between HL and higher odds of having additional consequences of unmet needs.
Conclusions: Our results show an association between HL and a higher number of ADL and IADL difficulties. Adults with HL may require increased support to address difficulties with daily activities and prevent experiencing related consequences.
Supplemental Material S1. Associations between hearing loss, ADL/IADL difficulty, and experience of unmet ADL/IADL-related needs (hearing loss modeled as continuous variable), National Health and Aging Trends Study, Round 12.
Supplemental Material S2. Associations of hearing loss, ADL/IADL difficulty, and experience of unmet ADL/IADL-related needs excluding participants relying on proxy response, National Health and Aging Trends Study, Round 12.
Supplemental Material S3. Characteristics of participants with self-reported ADL or IADL difficulty stratified by hearing loss category, National Health and Aging Trends Study, Round 12.
Bessen, S., Garcia Morales, E. E., Zhang, W., Martinez-Amezcua, P., Umoh, M., Cudjoe, T. K. M., Schrack, J. A., & Reed, N. S. (2025). Hearing loss, difficulty with activities of daily living, and experience of consequences of related unmet needs in older adults: A cross-sectional analysis. American Journal of Audiology, 34(1), 127–138. https://doi.org/10.1044/2024_AJA-24-00183
